Understanding Health Inequalities

What are ‘health inequalities’?

The term ‘health inequalities’ is usually used to refer to differences in health which exist between socio-economic classes (although there are other inequalities, for example by gender or race).  Health inequalities can be defined in a purely descriptive way.  For example, some researchers refer to health inequalities as “differences, variations, and disparities in the health achievements of individuals and groups” (Kawachi et al, 2002). Some people may feel that health differences are simply a matter of luck, or personal choices, and therefore not a matter for society or government to address. However, in UK research and policy, health inequalities are generally understood as the “systematic differences in health between different socio-economic groups within a society.” (Whitehead, 2007). In other words, ‘health inequalities’ refers to the different health experiences of richer and poorer communities.  Most researchers working on health inequalities in the UK believe that these inequalities reflect the way our society is organised and can, in theory, be prevented or avoided.  For these reasons, experts have argued that health inequalities are “unacceptable in a civilised society” (Whitehead, 2007) – in other words, health inequalities are something that society and the government should try to address. For more information about causes of health inequalities, you might be interested in these four videos(shown in the citizens’ juries)

How wide are health inequalities in the UK?:

Health differences vary depending on 1) what aspect of health is being considered (e.g. researchers might look specifically at a mental health issue, such as depression, or at a physical health issue, such as heart disease, or at how healthy people say they feel), and 2) which groups are being compared (e.g. researchers might compare people living in two different neighbourhoods or they might compare people who do different types of jobs). To give some examples, the difference in life expectancy between Jordanhill in Glasgow’s west end and Bridgeton in the east (a distance of only 4miles) is a startling 13.9 years for men and 8.5 years for women (McCartney, 2010). Likewise, a baby boy born in Manchester can expect to live in good health for 14 fewer years than a boy born in Richmond in London (Whitehead, 2014). Similarly, a baby girl born in Manchester can expect to live in good health for 15 fewer years (Whitehead, 2014).

How do researchers think that the Scottish and UK governments might be able to reduce health inequalities?

Although researchers tend to agree on the causes of health inequalities, they have different views about the best policy proposals for reducing health inequalities. It is not possible to summarise here all of the different policy proposals that researchers have put forward for tackling health inequalities in the UK – there are just too many! So what we are doing here is summarising 12 key policy proposals.

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